Size

Build: 15,069 sq. ft. / 1,400 sq. m.

Year

2015

Status

Completed

Client

Les Centres GHESKIO

Partners

Les Centres GHESKIO, Shelley and Donald Rubin Foundation

Adam Saltzman

Adam Saltzman

Principal, MASS.Build Director

Adam joined MASS in 2011, managing the Haiti office and completing the Ludwig Pavilion Multidrug-resistant Tuberculosis Hospital and Cholera Treatment Center, both for Les Centres GHESKIO in Port-au-Prince, Haiti. He then turned to manage MASS’s operations in Liberia, working with the Ministry of Health and the World Bank to plan the New Redemption Hospital Caldwell. Adam has also managed the Construction Administration for Equal Justice Initiative’s National Memorial for Peace and Justice in Montgomery, Alabama and Nyarugenge District Hospital in Kigali, Rwanda. Currently, he serves as Principal and Director of MASS Build leading the construction of The Ellen DeGeneres Campus of the Dian Fossey Gorilla Fund and the Rwanda Institute for Conservation Agriculture.

Prior to MASS, Adam assisted with recovery efforts in the aftermath of the 2010 Haiti earthquake through Architecture for Humanity. He also interned at Carazo Arquitectos in San Jose, Costa Rica, and Perkins + Will at their New York and Atlanta offices. Adam received his Bachelor of Business Administration in Finance from James Madison University and his Master of Architecture from the University of Cincinnati in 2011.

Adam is the director of the MASS.Build Team, helping MASS invest in local construction capacity in Rwanda and assist our partners in delivering projects that maximize value throughout the supply chain. Read more about MASS.Build.

Project Team

Sierra Bainbridge, Robertho Jean Noel, David Saladik, Adam Saltzman, Christopher Scovel, Amie Shao

Collaborators

Architectural and Landscape Design: MASS Design Group
M/E Engineer: Berelec
Structural Engineer: CBI Consulting
Civil Engineer: Fall Creek Engineering
Construction Manager: GBS Group, Raphael Izmery, Intl. Assoc. AIA
General Contractor: Chantiers d’Haiti
Landscape Consultants: Jardins & Accessoires

Haiti has the highest incidence of tuberculosis in the Western Hemisphere.

Photo of GHESKIO Tuberculosis Hospital, Photo by Iwan Baan, Exterior View from Middle of the Courtyard to the View of Ventilation Screens

© Iwan Baan

Tuberculosis is a highly contagious disease that requires treatment of up to twenty-four months. In the first two to six months of treatment, patients need to be hospitalized in isolation to prevent the spread of the disease. This extended seclusion, paired with severe side effects from treatment medication, can have significant impacts on patients’ mental health.

Photo of GHESKIO TB Hospital, Photo by Iwan Baan, Birdeye View of Hospital Highlighting Plan of the Building

© Iwan Baan

After the 2010 earthquake, the risk of tuberculosis transmission increased because large numbers of people were forced into living in crowded temporary housing camps. By some estimates, tuberculosis became three times more likely as compared to pre-2010 levels. And because much of the country’s healthcare infrastructure was badly damaged, many patients either lost access to treatment, or were cared for in tents.

Photo of GHESKIO Tuberculosis Hospital, Photo by Iwan Baan, Upstairs open-air corridor

© Iwan Baan

Photo of GHESKIO Tuberculosis Hospital, Photo by Iwan Baan, Process Photo of Construction Worker in Courtyard

© Iwan Baan

Photo of GHESKIO Tuberculosis Hospital, Aerial View of Hospital and Surrounding Port-au-Prince Neighborhood

© Iwan Baan

Despite these odds, GHESKIO had incredible success treating patients with multidrug-resistant tuberculosis (MDR-TB). Of their first 110 patients after the earthquake, 86 percent were cured or still receiving treatment—a number comparable to the most effective treatment programs around the world.

86%

Of their first 110 patients after the earthquake, 86 percent were cured or still receiving treatment—a number comparable to the most effective treatment programs around the world.

Photo of GHESKIO Tuberculosis Hospital, View of Courtyard from Second Level Exterior Hallway

The design of the new tuberculosis hospital focused on minimizing the risk of transmission while creating a more comfortable and supportive space to receive care. The hospital’s central feature is its interior courtyard and adjoining community spaces, where patients spend much of their stay.

Photo of GHESKIO Tuberculosis Hospital, Photo by Iwan Baan, Upstairs open-air corridor

© Iwan Baan

Flower and tree beds bring color, shade, and seating to the space. Bamboo screens covered in bougainvillea vines create visual privacy for the outdoor consultation spaces adjacent to patient rooms, allowing for conversations between patients and medical staff in the open air where transmission risk is lower.

Photo of GHESKIO Tuberculosis Hospital, Photo by Iwan Baan, Patients socialize in an outdoor area

© Iwan Baan

Photo of GHESKIO Tuberculosis Hospital, Photo by Iwan Baan, Patients socialize by the inner courtyard

© Iwan Baan

Photo of GHESKIO Tuberculosis Hospital, Photo by Iwan Baan, A Daytime image of the inner courtyard

© Iwan Baan

Strategies of passive ventilation and infection control help reduce in-hospital transmission of TB in this high-risk population, while lessening energy costs for the facility.

Photo of GHESKIO Tuberculosis Hospital, Photo by Iwan Baan, An Evening image of the inner courtyard

GHESKIO Tuberculosis Hospital, © Iwan Baan

The hospital controls airborne infection through permeable soffits and metal louvres that pull fresh air throughout the units. All corridors and consultation areas are outside to promote open-air circulation and reduce the risk of patient-staff contagion.

Photo of GHESKIO Tuberculosis Hospital, Photo by Iwan Baan, An evening image of the open-air corridors

© Iwan Baan

Cleaning staff can access the restrooms using a separate door from the outside to avoid entering the patient’s room and risking infection. The hospital accommodates 32 patient isolation suites, exam and x-ray rooms, offices, nurse stations, and two pharmacies, setting a new standard for TB care in Haiti.

elevation diagram of ventilation in the TB hospital
Diagram of a room in the TB hospital, displaying strategies for infection control and patient safety